Dialectical Behavioral Therapy (DBT)
DBT helps with the problematic actions sometimes used to deal with extreme emotional intensity. DBT emphasizes taking responsibility for one’s problems and helps the person examine how they deal with conflict and negative feelings. The goals of the DBT group include identifying maladaptive coping patterns and providing students with adaptive coping strategies to promote healthier lifestyles and psychological well-being. Several of our therapists, including DBT program leader Brad Simpson, are intensively trained in DBT.
DBT combines the basic strategies of cognitive-behavioral therapy with eastern mindfulness practices. DBT is based on the idea that opposites can coexist and be synthesized. Using this strategy in thought is found to be very useful with teen girls experiencing mood dysregulation and impulsivity. DBT calls on the girl to accept reality while maintaining a strong and conscious commitment to change. DBT has also been modified so that it can be used with other difficulties such as eating disorders, substance use, self-harm and anger management. DBT targets the issues that cause distress and teaches skills to deal with them without having to resort to self-defeating behaviors. It does so in a framework that helps us understand that we are doing the best we can even though we need to learn ways that work better.
DBT has proven so effective with our population that it is integrated into our entire program. In keeping with the structured approach that DBT favors, our girls carry diary cards with them throughout the day to track and monitor personal DBT goals, such as “respect” or “positive thinking.” Each day they review their diary in the context of a peer support group to practice giving and receiving feedback. In addition, Sunrise students have a bi-weekly DBT skills group, weekly yoga and mindfulness sessions, relational skills training, and individual and family DBT-focused therapy sessions. Parents and our entire staff-including non-clinical staff members-are given extensive DBT training so that they can assist with behavior chain analyses and other activities that reinforce our students’ DBT work. Incorporating DBT strategies into the daily routine, the milieu and our curriculum helps girls generalize their new skills into everyday life.
Dialectical Behavior group focuses on the following skills modules and associated problems:
- Mindfulness: focusing the mind, directing attention, understanding how you feel
- Emotional Regulation: reducing emotional intensity
- Distress Tolerance: reducing impulsivity, crisis management
- Interpersonal Effectiveness: keeping relationships steady, getting what is needed, and maintaining your self-respect